Student Information

Is the Participant over 18 years of age?

Birth Date (00/00/0000)

First Name

Last Name

Please Share Your Pronouns 🛈

She/Her

He/Him

They/Them

Other Other

Street Address

City

State

Zip Code

Phone Number

Email Address

Class Selection

Select Private Lessons or Group Class 🛈

Would you like in person lessons or online lessons?

Choose an Instrument

Do you have an instrument?

Preferred Day and Time for Lessons

0/750 characters

What kind of music, bands or performers do you like?

0/750 characters

Previous Music Experience

0/750 characters

Private Lesson or Program Goals

0/750 characters

How did you hear about music lessons and programs at Twin Town Guitars?

May we occasionally email you with updates about lessons, programs, events and instrument deal information? (We do not sell or share our customer information. That would be lame!)

Parent Information

Relationship to Participant:

Mother

Father

Guardian

Other Other

First Name

Last Name

Parent Phone

Parent Email Address

Permission/Release Information

Media Release Agreement
Twin Town Guitars occasionally uses recordings, pictures or videos of the students participating in private lessons and programs for educational/marketing purposes of the programs. By registering in this program, you are agreeing that you or your child may be a part of recordings, pictures, print and videos that may be used by Twin Town Guitars for educational or marketing purposes. If you have additional questions prior to completing the form, please contact the Twin Town Guitars Director of Music Education.

I have read and understand the Twin Town Guitars Media Release Agreement.

Yes, I agree.

No, I do not agree.

Participation/Permission Agreement

This form gives permission for me or my child to participate in and/or travel with Twin Town Guitars, its staff, volunteers, representatives, agents, for all Twin Town Guitars events for the duration of their participation in the Twin Town Guitars private lessons or programs.

Please read the following statements carefully: By selecting Yes, I Agree, you are releasing Twin Town Guitars, its employees, representatives, agents, and volunteers from any liability, personal injury, death, or property loss incurred in connection with the Event(s). You are also giving Twin Town Guitars, its employees, representatives, agents, and volunteers permission to seek whatever medical attention is deemed necessary in the event of an emergency and to provide preventative care to minor children. I/we understand that there are inherent risks involved with any trip or activity and, therefore, I/we agree (on behalf of myself, my spouse and/or my/our minor child) that Twin Town Guitars, together with its employees, representatives, agents, and volunteers shall not be responsible for and are hereby released from any liability for any personal injury, death, or property loss incurred in connection with the Event(s) of the time period noted above. I/we also authorize Twin Town Guitars to seek emergency medical treatment on behalf of me and/or my/our minor child in the event that such treatment is deemed necessary or appropriate by Twin Town Guitars and release Twin Town Guitars from any liability related to that decision or treatment. I/we further authorize the Twin Town Guitars to provide preventative care to me and my/our minor child, and release Twin Town Guitars from any liability related to that care. I/we understand that participation by me and/or my/our minor child in the Event(s) is voluntary. I/we further understand that any necessary transportation for the Event may be provided in vehicles driven by Twin Town Guitars or by third-party commercial carriers. I/we understand and agree that the scope of this release does not extend to willful, wanton, or intentional misconduct on the part of the Twin Town Guitars.

I have read and understand the Twin Town Guitars Participation/Permission Agreement.

Yes, I agree.

No, I do not agree.